Clindamycin
CLEOCIN
What it isLincosamide that inhibits the bacterial 50S ribosome; anaerobic, dental, and skin infections.
Why this oneAnaerobic and gram-positive coverage plus toxin suppression makes it especially useful in necrotizing infection.
What limits itIt is the classic antibiotic trigger for C. difficile colitis; inducible staphylococcal resistance may require a D-test.
FDA-approved for
- bacterial infections (~1970)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Serious infections | Adult | 150-300 mg q6h (QID) | ||
| More severe infections | Adult | 300-450 mg q6h (QID) | ||
| Serious infections | Pediatric | 8-16 mg/kg/day divided in 3-4 doses | ||
| More severe infections | Pediatric | 16-20 mg/kg/day divided in 3-4 doses |
Renal Undefined
Hepatic Undefined
Instructions
- Take with a full glass of water (6-8 oz) and at least 30 min before lying down to reduce esophageal irritation
- Discontinue if significant diarrhea occurs
- Dose by total body weight regardless of obesity
- Beta-hemolytic streptococcal infections: treat at least 10 days
Cautions
- C. difficile-associated / pseudomembranous colitis (may be fatal)
- Severe cutaneous adverse reactions (TEN, SJS-like, DRESS, AGEP)
- Anaphylaxis and hypersensitivity reactions
- Esophagitis and esophageal ulcer (take with water, remain upright)
- Jaundice/abnormal liver function tests; acute kidney injury
- Blood dyscrasias (neutropenia, agranulocytosis, thrombocytopenia)
Adverse reactions
- Abdominal pain
- Pseudomembranous colitis
- Nausea
- Vomiting
- Diarrhea
- Morbilliform rash
- Metallic taste
Pregnancy Systemic use in 2nd and 3rd trimesters not associated with increased congenital abnormalities; use in the first trimester only if clearly needed.
Lactation Undefined
NO BOXED WARNINGS
Principal riskClostridioides difficile colitis
Cost, est. cash$10–$500/month
Generic entryPre-1982
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Clindamycin ballicule
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